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Exploring the utility and scalability of entrustable professional activities beyond medical education: A scoping review protocol

Jagannathan, A.; Micallef, J.; Sanchez, O.; Dubrowski, A.

2025-08-11 medical education
10.1101/2025.08.10.25333060 medRxiv
Show abstract

Competency-based education (CBE) is gaining prominence in post-secondary education due to its effectiveness in optimizing workforce readiness. However, assessing competence and workforce readiness presents a significant challenge. Entrustable professional activities (EPAs) offer an effective solution by translating competencies into observable, measurable, and entrustable tasks. While EPAs have been widely adopted in medical education, their application in non-clinical educational contexts remains minimal. This scoping review aims to map the diffusion of EPAs beyond medicine and assess their scalability to undergraduate non-clinical minor pathways, which are ideal piloting sites for EPA-based assessment frameworks. Guided by Rogers Diffusion of Innovations theory, this review will identify the barriers and facilitators influencing the adoption of EPAs in non-clinical educational contexts. Following Arksey and OMalleys framework, this review will progress through five stages: identifying the research question, identifying relevant studies, study selection, charting the data, and reporting results. Searches will be conducted across Ovid MEDLINE, CINAHL, Scopus, ERIC, and grey literature. The research question is: "How have EPAs been developed and implemented outside of medical education, and what factors influence their adoption in non-clinical training programs?" The search will include articles describing the development or implementation of EPAs outside medicine and will exclude irrelevant studies. Titles and abstracts will be reviewed first, followed by a full-text examination of relevant articles. Data will be extracted, organized, and summarized to highlight key findings. Two reviewers will ensure quality during screening and data extraction. Findings from this scoping review will inform the rationale for scaling EPAs to non-clinical training programs and offer insights to guide the adaptation, development, and implementation of EPA-based assessment frameworks in undergraduate non-clinical minor pathways, addressing pressing challenges in CBE and creating a replicable model for future program development. Findings from this scoping review will be submitted for publication in a scientific journal.

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